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Fludarabine
See also Cytotoxic and immunosuppressant drugs
General information
Fludarabine phosphate is a purine nucleoside antitumor agent, which inhibits adenosine deaminase. It is mainly used to treat chronic lymphocytic leukemia. Dose-limiting myelotoxicity, nausea and vomiting, and raised liver enzymes were observed during early clinical studies. The most common adverse effect is myelosuppression (grade 3 or 4), and other common adverse reactions include infections and gastrointestinal disturbances, although these are usually of mild to moderate intensity (grade 1 or 2) [ ].
Organs and systems
Respiratory
Fludarabine can cause interstitial pneumonitis [ , ].
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A 73-year-old woman developed fever and cough 2 weeks after completing a third cycle of fludarabine for chronic lymphocytic leukemia. A chest X-ray showed multiple pulmonary nodules and a biopsy showed a mononuclear interstitial infiltrate without evidence of malignant, infectious, granulomatous, or vascular causes. Her symptoms and pulmonary nodules resolved after treatment with glucocorticoids [ ].
There has also been a report of an acute eosinophilic pneumonia associated with peripheral blood eosinophilia in a patient with follicular lymphoma [ ].
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